Medical students take time off during school for a multitude of reasons including inability to decide on a specialty, obtaining another degree, doing research, and various life circumstances (pregnancy/giving birth, unforeseen family events, burnout, and personal health). Regardless of why you take time off, taking a year off for a whatever reason while you’re in medical school is a big decision. Many students see it as “just one more year” out of a long medical training process that lasts at minimum 11 years including college, medical school, and residency. Although 1 year does not seem like a long time in the big scheme of things, there are important factors that you need to consider before making that decision.

Ultimately, taking a year off is at the very least a $200,000 decision. Delaying becoming an attending for one year is essentially losing one year of attending salary. Although physicians often live very comfortably financially after becoming attendings, $200,000 is still a lot of money. If you are going to become a surgeon, that number might be $400,000 or higher. How would you feel if someone came up to you and said that they were going to take $200,000 from you in 10 years? You may not feel the effect of it now but you may regret it later.

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Many students take time off because of their specialty choice. Taking one year off to do research and get abstracts and publications can be very helpful if you are interested in competitive specialties like dermatology, neurosurgery, head and neck surgery, urology, etc. Many of these surgical specialties view research highly. Nevertheless, doing this research year can be avoided (except probably neurosurgery where taking at least one year off seems to be an unwritten rule) with good preparation. As a medical student, if you know that you are remotely interested in a competitive specialty, start doing research your first year and keep going all the way through your fourth year until you apply to medical school. Undoubtedly this is enough time to get a few presentations and publications without dedicating a whole year to research. Most competitive specialties do not require you to have research in their specific field. So if you were doing head and neck surgery research for 3 years and you’ve obtained 3 publications but you decide last minute that you want to do dermatology, your publications and research experience still matter. You shouldn’t need to a year off to do a research year specifically in dermatology. However, if you were planning to do family medicine and did no research for the first three years and then all of a sudden you decide you want to do dermatology and your step 1 score is not absolutely amazing, you may need to take one year off to do research. You can also avoid having to do a research year for the sake of applying to residency by diligently studying for step 1 and obtaining a great score. An amazing step 1 score opens many doors.

From a residency standpoint, obtaining an additional degree such as an MPH or MBA during medical school doesn’t hold much value. Having this additional degree does not make up for a bad step 1 score or lack of research. You should not take a year off to obtain an additional degree if you’re doing it because it will help your chances at getting the residency spot that you want. You should only take time off to obtain one of these degrees if you are truly passionate about the subject and want to pursue the subject in the future. Nevertheless, keep in mind that as a physician, you often don’t need additional degrees to pursue anything. For example, you don’t need an MPH to do public health work as a physician in the future as long as you can obtain the public health training in a different way.  

Students sometimes are forced to take a year off because they cannot decide their specialty by the middle or end of their third year. You should try to avoid this circumstance at all costs. In the long run, it’s better to make the “right” choice and lose a year than to make the “wrong” specialty choice and apply to a specialty that you are ultimately unhappy with. However, if you are undecided about your specialty after three years of medical school, there is no guarantee that one additional year will give you that light bulb moment that you are looking for. Avoid this situation by being proactive early in medical school. Shadow, make pros and cons list, rule out specialties you definitely don’t want to pursue, and ask residents and attendings what you should look for in a specialty. Don’t let indecision cost you a year of your life and $200,000.

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Students that have to take a year off because of various life circumstances often times have no choice. If your health is failing, you need to get that addressed first prior to continuing. However, despite life’s various unforeseen circumstances, most of them do not require you to take an entire year off. Prior to committing to take a full year break, talk to your school administrators to see what options there are. Can you take a quarter off? One rotation? One month? Medical school administration has become increasingly understanding of their students, especially if it is because of mental health reasons.

Taking a year off during medical school is not a bad thing. But before you decide to do it, make sure you are doing it for the right reasons. Explore your options as much as possible to make sure you are doing the right thing!

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Edward Chang

Edward Chang is the Co-founder and Director of Operations of ProspectiveDoctor.com. He graduated from the David Geffen School of Medicine at UCLA and is currently a urology resident at the University of Washington. He also attended UCLA as an undergraduate, graduating with a major in Molecular, Cell, and Developmental Biology. If you are interested in contributing to ProspectiveDoctor.com, please contact him at edwardchang@prospectivedoctor.com. Follow him on Twitter @EdwardChangMD and Prospective Doctor @ProspectiveDr.

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